Disease relevance of Overdose

• Acetaminophen ingestion accounted for 12 percent of all patients hospitalized with overdoses (71 of 589) and 40 percent of patients with acute liver failure (10 of 25) during the study period [1].
• Octreotide reverses hyperinsulinemia and prevents hypoglycemia induced by sulfonylurea overdoses [2].
• Delayed sequelae after acute overdoses or poisonings: cranial neuropathy related to ethylene glycol ingestion [3].
• In rats, the Ca2+ antagonist verapamil not only prevented arterial calcinosis due to overdoses of vitamin D and dihydrotachysterol but also counteracted age-dependent Ca2+ accumulation [4].
• The low incidence of severe toxicity in children after overdoses of APAP may be related to greater capacity to metabolize APAP via a nontoxic pathway [5].

Psychiatry related information on Overdose

• Numerous case reports have documented that phenylpropanolamine (PPA) stimulates the central nervous system with symptoms ranging from anxiety and hallucinations to grand mal seizures produced by overdoses [6].
• Even the most extensive information on cocaine overdoses, that of the Drug Abuse Warning Network, is severely limited for purposes of examining this topic [7].
• The Indian community has significantly higher risk of parasuicide compared to the Chinese and Malays. Overdose of medication was the most common method with paracetamol being implicated in 48.1% of all overdoses [8].
• Several papers addressed the issue of accidental versus intentional overdoses, the role of alcohol consumption as a risk factor, and newer aspects of treating and preventing acetaminophen injury to the liver [9].

High impact information on Overdose

• Fluoxetine does not have the anticholinergic, hypotensive, and sedative effects of tricyclic antidepressant drugs and has no particular cardiovascular effects; overdoses do not cause serious toxic effects [10].
• Concentrations of PCP that produced near-maximum contractile responses on cerebral arteries were similar to those in the blood and brain of human subjects who had died from PCP overdoses [11].
• RESULTS: A threshold temperature of 31.1 degrees C (88 degrees F) was identified, above which the mean daily number of fatal cocaine overdoses increased steadily [12].
• Morphine was detected in the blood of five persons (31%) and cocaine in the blood of three persons (19%) dying of 3-methylfentanyl overdoses; these were demographically similar to 99 other fatal overdose cases investigated by the county coroner from 1986 through 1988 [13].
• We treated two patients with phenobarbital overdoses with the nasogastric administration of multiple doses of activated charcoal [14].

Chemical compound and disease context of Overdose

• Letter: Overdoses of chloramphenicol [15].
• Five fatal cases of serotonin syndrome after moclobemide-citalopram or moclobemide-clomipramine overdoses [16].
• Deaths after overdoses of orphenadrine [17].
• Fatal temazepam overdoses [18].
• Acute doxorubicin overdoses [19].

Biological context of Overdose

• Pharmacokinetics of naproxen overdoses [20].
• Sodium polystyrene sulfonate may be useful clinically for gastric decontamination after lithium overdoses [21].
• After 16 weeks of increase in the arterial blood pressure, the animals were sacrificed by overdoses of sodium pentobarbital and perfused intracardially with a 0.9% saline solution [22].
• Saturable clearance may cause higher bioavailability and slower elimination of verapamil after acute oral overdoses [23].
• From these results, it appears that PGF2 alpha has no effect on the absorption and exsorption of imipramine across the intestinal membrane although it is reasonable to use PGF2 alpha in the case of patients with overdoses of drugs which decrease gastrointestinal motility [24].

Anatomical context of Overdose

• METHODS: As retinoic acid cannot be visualized directly, we mapped its actions in the forebrain with indirect morphologic methods and by applying retinoic acid overdoses to early postnatal mice [25].
• MAIN RESULTS: Hypotension, sinus node suppression, and dysrhythmias often occur with calcium channel blocker overdoses, but atrioventricular nodal block occurs more often with verapamil (chi 2 test, P < .025) [26].
• CONCLUSION: These results suggest that morphine, cocaine and methadone are activated into free radicals which produce membrane lipid perturbation and histamine release, suggesting that a massive release of mast cell histamine could be an additional risk factor in heroin and cocaine overdoses [27].

Gene context of Overdose

• Results showed a decrease in catalase activity of the PFC and ST after SE and death induced by cocaine and bupropion overdoses [28].
• Therapeutic doses of the COX-2 inhibitors and overdoses of acetaminophen have been associated with the development of occasional cases of acute renal failure [29].
• The increasing use of MAO-A inhibitors and SSRIs in the treatment of depression suggests that careful clinical observation is required when combination overdoses are suspected [30].
• Coma blisters have been reported after drug overdoses, but clinically similar blisters (not tested by biopsy) have been seen in other cases of coma [31].
• Twelve percent of alprazolam overdoses had a GCS < 9 compared with 10% for other benzodiazepines [32].

Analytical, diagnostic and therapeutic context of Overdose

• Column hemoperfusion with Amberlite XAD-4 resin was simpler and more effective than any known method of removing barbiturates and glutethimide from the blood of patients with drug overdoses [33].
• Emergency therapy of sulfonylurea overdoses with glucose is often unsatisfactory because glucose stimulates insulin release and initiates a need for escalating quantities of hypertonic glucose to maintain normoglycemia [2].
• Serious iron overdoses require chelation therapy with deferoxamine [34].
• Multiple-dose sodium polystyrene sulfonate may be useful in lowering the serum lithium level of select patients with acute lithium overdoses but is not a substitute for hemodialysis in severely ill patients [35].
• METHODS: Patients with a clinical suspicion of gamma-hydroxybutyrate-like drug overdoses and a Glasgow Coma Scale score of 8 or lower were identified from July 1998 through January 1999 [36].

References